Ann and Eric Fisherman at MGMA speaking with Tee Green, Founder, President and CEO of Greenway
Ann Fishman: Ann and Eric Fisherman at MGMA. We are with Tee Green, Founder, President and CEO of Greenway. Thank you for being with us, Tee.
Tee Green: Thank you, Ann and Eric.
Dr. Eric Fishman: So, Tee, we have spoken many times and certainly it was a few years ago, one of your big announcements was having to do with getting Prime Suite available for research capabilities and that’s probably small potatoes now. At this point in time, it’s probably a very small niche but let’s talk about that then we will go into some of the much more recent events that have occurred where Greenway has exploded as, you know…
Tee Green: Sure. You are referring to PrimeResearch.
Dr. Eric Fishman: Absolutely.
Tee Green: And PrimeResearch is a portal that was designed in the very beginning of Greenway from Prime Suite all the way through the PrimeResearch. PrimeResearch was the vision <<inaudible>> saying if you think about our healthcare system today, I would argue that it’s not a system because systems do what? They get smarter, they get faster, and they get stronger. Can you really say that about our healthcare system? Then, let’s call on the healthcare something and now we are beginning to build a smarter healthcare system and PrimeResearch is a key component of that. Let’s take disease that impact you or your family – let’s take diabetes, let’s take autism, Alzheimer’s which is applicable in my family, heart disease, cancers – and think about from Ann and Eric, from birth until today how much of your information is going anywhere to advance the study on any of those diseases.
Dr. Eric Fishman: Not too much.
Ann Fishman: Very good point.
Tee Green: Not too much. That’s not a very smart system. So, what PrimeResearch begins to allow us to do is take the frontline of medicine, the ambulatory business of medicine, and connect it directly to life sciences so that as a consumer of healthcare now you can walk into Eric’s office and say, “Eric, I know my genetic scan because the code is already done and I know I am predisposed to] Alzheimer’s genetically and I want my de-identified information to be routed directly to the official registry anytime I come and see you.
Dr. Eric Fishman: And there are some – and Anne is particularly interested in this – who have some concern about the privacy that it may not be as de-identified as you would like.
Tee Green: But I directed you to do that – the consumer. Tee Greens said “Eric, I want you to wrap my information officially.” I am directing that communication and that’s what’s powerful.
Ann Fishman: Can you foresee a scenario where someone would unwillingly have their information passed along for research purposes?
Tee Green: By accident or by the patient not knowing?
Ann Fishman: Either.
Tee Green: Yes, sure – by accidents, probably less likely because of the technology and the protocols of security. Do you know that somebody has access to every prescription you have ever taken?
Dr. Eric Fishman: And it sits on an open chart in some offices <<inaudible>> patient to take a look at that.
Tee Green: They have routing and aggregators of that information and I don’t think patients quite understand that. So, I think education is critical, I think policy is going to be critical, but you know who is going to drive it? The consumer. If you go back to 1992, how many people said “I would never put my financial information online.” Do you know where was your checkbook yesterday? So, it’s just tiny and it’s education or the consumer will drop because we have to build a smarter system. We have to build a system that will learn as it evolves. You just think about the amount of information we captured on Alzheimer’s patients, cancer patients and autism patients that are stored in paper charts all over the United States. That information is worthless.
Dr. Eric Fishman: They saw it decades ago in the Framingham Study in Massachusetts for heart disease and that is such a tiny microcosm in comparison to what can be done. So, PrimeSuite – you have chosen a name that’s pretty appropriate – has a large number of components. We will get the Prime Speech in just a second. How many different components are there at this point in time in PrimeResearch, PrimeSpeech…
Tee Green: Inside our infrastructure, the kernel is PrimeSuite, everything builds of PrimeSuite. And PrimeExchange is a detail liquidity engine that allows us to do a lot of it, taking all of the information in PrimeSuite systems around the country and be able to route it to third party, receive information from third party, route it back into the correct physician system as well as the patient’s chart, recognizing that if you go three years down the road do I know where Ann and Eric are going to be required to send data to. I don’t have any ideas. Do I know who you are going to be required to receive data from? I don’t know that. Do we know what standards we are going to use? No. Do we know a transfer protocol? What security protocols? Does anybody know that…?
Dr. Eric Fishman: We have got a pretty good understanding of what we don’t know here.
Tee Green: What we know is we are going to have to do it. So, you have to have the technology platform that allows that and that’s what PrimeExchange does. And then PrimePatient is the third component of this infrastructure and that is what allows you, a physician, to communicate directly with your patients. Whether your patient has a Healthpod account, an Intel portal, a dossier portal, it could be a Relay Health portal, it could be a Google Health once that one’s launched, you as a physician’s office are going to have to offer all of those to your patients. Of course, you can’t tell the consumer that they can only use this technology; that will be a disaster. So, PrimePatient gives that vehicle. Then there is PrimeResearch and that’s the four pillars of this infrastructure; and over time we have launched PrimeMobile which is your iPhone, your iPad. We have Droid version coming in out after the first of the year. We will do the new Windows platform and then we have PrimeEnterprise which is our large technology that allows health systems to manage hundreds of ambulatory systems out in the community. And then we have a revenue cycle service called PrimeRCM because we believe over the next decade as we move away from fee for service or what we call production medicine, we are going to move into quality and outcomes medicine; that changes the revenue cycle. Most revenue cycle is built around ICD9, CBD, and maybe some modifier to get a claim pay. Well, now you are going to have to prove that the patient actually got that. So, you start having a clinically driven revenue cycles which is going to change the game as it relates to revenue cycle services. So, we have PrimeRCM.
Dr. Eric Fishman: And, as you mentioned, at the end of this week PrimeSpeech – <<inaudible>> about PrimeSpeech and how you see that playing out?
Tee Green: PrimeSpeech is a way that as we were entering more and more high volume practices, especially orthopedics, when you get into that environment, template-based documentation using stylus and laptops, when you are doing that many – 60, 70, how many patients do you see a day…?
Dr. Eric Fishman: We hit 90 on a very busy day, 60 and 70 is common.
Tee Green: We were trying to always – one of the four principles behind PrimeSuite is to be the most usable technology in the industry. So, it required us to go out and find different ways to allow different types of physicians to interact with the core technology and speech recognition has always been a neat thing, but it has always been very cumbersome to use; and once we could integrate natural language processing directly inside PrimeSuite, directly inside of your workflow, then we said Wow, that’s innovative and that could change the way a busy ortho who see 90 patients today practice medicine.
Dr. Eric Fishman: It wasn’t 90 all the … Has that been implemented?
Tee Green: No, it will go live after the first of the year.
Dr. Eric Fishman: Okay.
Ann Fishman: Now that the final rules have come out for meaningful use, do you anticipate widespread EHR adoption in the near future?
Tee Green: Yes. The question is what does near future mean. Yes, we will electronify this industry. I mean, we just don’t know how long it’s going to take. If you look at meaningful use which is obviously the outcomes of the hi-tech ad, if you look at what that’s that doing, it’s like artificial stimuli, an artificial DNA has been injected into this industry; but we will transform this industry. Whether it happens in three years, five years or ten years, I don’t know; but I think you are seeing a massive cultural shift in the management positions that have said “Okay, I know I have to move off paper-based documentation.” So, that was a biggest hurdle. Now, we are into the execution.
Ann Fishman: How do you see a potential single payer system in the US? Would that be the natural end-result of the recent Obama healthcare reforms? How will that impact this industry or how will this industry impact that part of healthcare.
Tee Green: Well, a single payer system, in my opinion, would be a disaster because it will absolutely stifle innovation; and I think that would be the worst; and to be honest with you, I don’t think consumers in the United States will allow it to happen because we know those of us that are in this business, I know what advanced care is. Hopefully, as a country we are smarter than…
Dr. Eric Fishman: Let’s talk about security for just a second. It’s something that is on some people’s minds and it’s something which I think 98% - I will make up a number – 99% of Americans, maybe small, hate <<inaudible>> “put your information here and it will be secure”; and there is a number of very vocal opponents of this entire system of getting a phenomenal amount of information available in case of a glitch, and what type of steps does Greenway take to minimize any issue of that nature?
Tee Green: Well, I think with any systems and design, you have to be very diligent in innovation and how you design security and how you design your processes around that and then how do you teach those processes to people that are going to be using this technology. That’s absolutely core to what an organization like Greenway has to do; but then you have legislation regulation that has to evolve.
Dr. Eric Fishman: And Greenway as a company has very significant <<inaudible>>. You got people living in Washington.
Tee Green: Very active in what these policies are going to look like as they come down the pipe. The good thing is we have an industry that is known before and that’s financial services. So, there is a model that has proven it worked; it’s not perfect but there is a model that worked and I think as the consumers become more educated, we are going to fast-forward 15 years from now and I don’t think anybody in this conference is going to be talking about security of their healthcare information just like we don’t sit down and talk about the security of our financial information.
Dr. Eric Fishman: Many years ago I thought of Greenway as a client server product and you have expended the offerings and you got softwares of service cloud. What options are there for a physician to acquire the technology and what would the physician do if they wanted to see something in action actually using it?
Tee Green: Well, two things – if they want to acquire the technology, you are right, there has been a tremendous shift towards clouding computing over the last 5 years, and I think if you look at the majority of our infrastructure, it was out in the cloud and we think you will just continue to see that, we think technology platforms are going to be somewhat independent because whether or not we are running on the Microsoft back-end or Oracle back-end or Linux back-end, I don’t think the customers are going to hear when they are subscribing to that service.
The second part of your question – we have thousands and thousands of customers all over United States. So, I would encourage anybody to find out who their Greenway representative is and we can certainly arrange for <<inaudible>>.
Dr. Eric Fishman: You certainly have got an interesting outlook on this industry – I am going back to your <<inaudible>> - a lot of interesting analogies.
This is Eric Fishman in New Orleans at MGMA 10 and we had the pleasure of speaking with Tee Green. Thank you.